Information about immunizations

We follow the immunization schedule as set by the Advisory Committee on Immunization Practices (ACIP), American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP).  This schedule is updated yearly and regularly incorporates new vaccines and revised recommendations.  The vaccines given protect against the following illnesses:

We also carry the influenza vaccine in the fall.  The ACIP and AAP recommend that all chronically ill children and children between 6 months and 18 years receive the influenza vaccine.  We also carry several vaccines, such as the Hepatitis A vaccine, which may be needed for travel.

While all vaccines are extremely safe and have been extensively tested, there are potential minor side effects for all of them.  The most common side effects are a low grade fever and irritability.  For more information, refer to the vaccine handouts given in the office or to the web sites listed at the end of this page.

For the exact schedule of immunizations, refer to the well child visit schedule shown under the "About our practice" section of this web site.

Frequently asked questions about immunizations

1.  Is it safe for a baby's immune system to give so many shots at once?
From the moment a child is born, that child's immune system is bombarded by thousands and thousands of bacteria and viruses.  The number of "antigens" (important protein markers that a child's immune system recognizes in a vaccine to build immunity against) that are given in routine immunizations pale compared to what the child's body is already seeing.  In fact, today's vaccines challenge the body's immune system far less than ever before.  Because of continuous refinements achieved in vaccine manufacturing, the eleven routine vaccinations today have fewer than 130 total "antigens" that the body reacts against.  One single dose of smallpox vaccine used to contain over two hundred!  Of note, the Institute of Medicine published a report in 2002 that found no increase in serious infections, such as pneumonia and meningitis, and "autoimmune diseases", such as diabetes, in recent years with the increase in routine immunizations.

We have had several requests to "split up" the routine vaccinations and give no more than 2, or even 1, vaccine at a time.  We do not recommend this.  There is good scientific evidence supporting both the effectiveness and the safety of the routine childhood vaccines as given by the recommended schedule.  There are no studies that prove that splitting the administration of the vaccines has any safety benefit.  In addition, there are no studies that have examined whether the vaccines, if separated by intervals that are not recommended by the CDC, will be as effective as giving them by the recommended schedule!

2.  Do any of your vaccines contain mercury?
None of the routine childhood immunizations we give contain any mercury.  The mercury contained in some vaccines is part of a preservative called thimerosal that has been in use since the 1930s.  While the dose of mercury contained in thimerosal is tiny, the proliferation of vaccines given to young infants that occurred in the 1990s led the American Academy of Pediatrics to recommend in 1999 that thimerosal, as a precaution, be eliminated from routine vaccines.  The only vaccine we carry that contains thimerosal is the influenza vaccine for children over the age of three.  (We do have a thimerosal-free flu vaccine for children over the age of three.)  It contains a trace of mercury that is far below the limits established by the FDA, EPA, and WHO, even for young children.  It should be noted that no harm has ever been attributed to thimerosal given in vaccines prior to 1999.  Read our office handout on thimerosal for more information.

3.  Can my child receive vaccines during an illness?
Vaccines will work regardless of whether a child is sick or well.  We do defer vaccines in case of moderate to high fever so that there is no confusion as to where the fever is coming from in the event of a vaccine reaction.  If your child has a mild illness, such as a cold, or a low-grade fever, he or she may receive her immunizations that day.

4.  Which vaccines are made from live viruses?  Are there any additional risks?
The only vaccines routinely given that are made from live viruses are MMR (Measles-Mumps-Rubella) and Varicella (chicken pox).  There is a small risk that your child may develop a rash and/or fever from these two vaccines, but almost all children receive these two vaccines without any complications or side effects.  The live virus polio vaccine (OPV) is no longer used.  Influenza vaccine is made from an inactivated virus and there is no chance of contracting influenza from the vaccine.

5.  What are the chances of my child developing polio from the polio vaccine?
There is no chance of developing polio from the inactivated polio vaccine (IPV), which is the only vaccine currently in use in the United States.  The oral polio vaccine (OPV), used for many years, was a live virus vaccine and had a one in 2.4 million chance in causing polio in a child.  Although OPV is a more effective vaccine, polio is no longer endemic to the United States, and as of January 1, 2000, OPV is no longer used.

6.  Why should my newborn baby get the Hepatitis B vaccine?  Isn't Hepatitis B contracted only through contact with body fluids, such as blood transfusions and sexual intercourse?
Universal immunization with Hepatitis B vaccine was recommended in 1992 because of the 30,000 children diagnosed annually with Hepatitis B, only one third of them were actually found to have a known risk factor such as blood transfusions or maternal infection.  The Hepatitis B virus lives for up to a week on solid surfaces.  A person who contracts Hepatitis B can develop a "chronic" infectious state, which may lead to cirrhosis, liver failure, and cancer in adulthood.  While only 5% of adults develop chronic infection, 90% of infected newborns and 70% of infants will develop a chronic infection.

7.  Is the MMR vaccine associated with autism?
No.  The original study that attempted to link MMR and autism, done by Wakefield and colleagues and published in Lancet in 1998, was highly flawed due to a small sample size and erroneous data.  In February of 2004, the Lancet published a retraction of the study after it found out that Dr. Wakefield had not disclosed his relationship with consumer groups seeking to sue vaccine manufacturers--at the time no links had been reported between MMR and autism.  Large population based studies done here and in several European countries have found no association between the MMR vaccine and autism.  The exact cause of autism is not known, but current research implicates both genetics and prenatal events.  The reasons why the rate of autism are still being investigated, but increasing awareness of the disorder and a broader definition of the disorder are significant reasons why.  Read our office handout on the MMR/autism controversy for more information.

Helpful web links

Childhood Immunization Support Program

National Network for Immunization Information

Centers for Disease Control and Prevention

Children's Hospital of Philadelphia

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